Opinions needed ........

[letstalk1]

This is something I have wondered about for some time as I understood anyone with diabetes was automatically prescribed low doseage aspirin until recently. Why it was prescribed I do not know. Why the practice stopped I do not know Whether or not there is a connection between not being prescribed aspirin, being prescribed statins and the "save the NHS money" mantra seems to depend on who I am speaking to. I do know my hip replacement surgery guidelines tell me not to take aspirin or warfarin. Can you explain the history and connection between aspirin and both T1D and T2D?

I can not explain the history- dont know it. I have found also depends on who you talk to about the why and why nots to take low aspirin..

 

[desidiabulum]

Just in case it's relevant to anyone -- you shouldn't combine omeprazole with clopidogrel (I pointed this out to a certain rather famous hospital who put me on both and they said 'oops yes -- right')

 

[DeejayR]

Sorry about your mom. Not fair! I doubt if preventatives would have helped. You'd think that if you stayed on the pavement all your life you'd never get run over, but alas that's not the case. I have set a course of diet, exercise and minimal medication and if at any time I feel out of sorts I try to do something about it. I also think that if you want to take low-dose aspirin daily and it makes you feel a bit more comfortable, do it. My old GP prescribed it for everything. "Have a bucketful," he used to say, "they're cheap!"

 

[DavidGrahamJones]

I often wonder if she had been on some preventatives if it may of made a difference

You will never know for sure. When and if someone goes through life without the need to see a doctor regularly, I sometimes wonder if that means they're in perfect health. For example, my brother, now 63, boasts how he never has to see a doctor, but has no idea about his blood pressure and blood glucose, because he feels well. It can change rather rapidly as we get older. I don't think any of us can be 100% sure of what the future holds, we can try and do all the right things and the rest of it is up to . . . . . . . . .

 

[derry60]

Yes, if taken long term.

Important warnings

• Severe diarrhea warning: This drug may increase your risk of severe diarrhea. This may be caused by an infection in your intestine caused by the bacteria Clostridium difficile. Call your doctor right away if you have watery diarrhea, stomach pain, and a fever that won’t go away.
• Bone fractures warning: People who take several doses of a proton pump inhibitor drug, such as omeprazole, every day for a year or longer may have an increased risk of bone fractures. These bone breaks may be more likely to happen in your hip, wrist, or spine. Talk to your doctor about your risk of bone fractures. You should take this drug exactly as prescribed by your doctor. They should prescribe the lowest dose possible for the shortest amount of time needed for your treatment.
• Low magnesium levels warning: Taking this drug for 3 months or longer can cause low magnesium levels in your body. Your risk is higher if you take omeprazole for a year or longer. Call your doctor right away if you have symptoms of low magnesium. These can include seizures, abnormal or fast heart rate, jitteriness, jerking movements or shaking, and muscle weakness. They can also include cramps or muscle aches and spasms of your hands, feet, and voice box. Your doctor may check your magnesium levels before and during your treatment with this drug.
• Cutaneous lupus erythematosus and systemic lupus erythematosus warning: Omeprazole can cause cutaneous lupus erythematosus (CLE) and systemic lupus erythematosus (SLE). CLE and SLE are autoimmune diseases. Symptoms of CLE can range from a rash on the skin and nose, to a raised, scaly, red or purple rash on certain parts of the body. Symptoms of SLE can include fever, tiredness, weight loss, blood clots, heartburn, and stomach pain. If you have any of these symptoms, call your doctor.

http://www.healthline.com/health/omeprazole-oral-capsule-sprinkles#important-warnings2

Oh dear, all sounds very dire, doesn't it...Almost every pill that we take has these sort of warning on. The majority of people will probably not get any of the above side effects. I have been taking them for near on 13 years and have to say I have no side effects at all. Even my heart pills will give a list of scary side effects. Even my Blood Pressure tabs will give very scary side effect list. They are usually guidelines.

 

[derry60]

Just in case it's relevant to anyone -- you shouldn't combine omeprazole with clopidogrel (I pointed this out to a certain rather famous hospital who put me on both and they said 'oops yes -- right')

The only reason for that is because Omeprazole will interfere with the workings of Plavix , Omeprazole makes Plavix less effective

 

[Bluetit1802]

Oh dear, all sounds very dire, doesn't it...Almost every pill that we take has these sort of warning on. The majority of people will probably not get any of the above side effects. I have been taking them for near on 13 years and have to say I have no side effects at all. Even my heart pills will give a list of scary side effects. Even my Blood Pressure tabs will give very scary side effect list. They are usually guidelines.

This is a warning - it is not a guideline. You can see everywhere the same warnings for Omeprazole. You are right, not everyone suffers these side effects, so maybe you are one of the lucky ones.

 

[derry60]

This is a warning - it is not a guideline. You can see everywhere the same warnings for Omeprazole. You are right, not everyone suffers these side effects, so maybe you are one of the lucky ones.

This is it bluetit and there are so many others on this medication that do not suffer any ill effects. I think that we have to be careful at times because none of us would take any advice from our doctors at all. I had a friend who was a nurse who worked on the cardiac ward and she said that lives could have actually been saved if heart patients took their medicine, some people were either not taking their medication at all or not on a regular basis.

 

[Bluetit1802]

This has just been posted on another thread.
https://www.gp-update.co.uk/files/docs/GP_Update-Spring_2013_diabetes.pdf

There is a section on Aspirin and diabetes, which says:

Aspirin in diabetes Let’s be clear, in someone who has had stroke or heart attack we would use anti-platelets as SECONDARY PREVENTION (but probably clopidogrel, not aspirin, as discussed in the Cardiovascular chapter). This is true whether or not they had diabetes. In PRIMARY PREVENTION in non-diabetics, there is now a significant body of evidence that using aspirin is not indicated, because the benefits are minute.

We have always assumed that some populations at higher risk of CVD (such as diabetics), may still benefit from aspirin. The latest evidence suggests not! Two high quality trials have now confirmed that aspirin should NOT be used in PRIMARY prevention (POPADAD, BMJ 2008;337:a1840; Japanese RCT , JAMA 2008;300:2134).

A further meta-analysis of primary prevention of CVD in diabetics also concluded that aspirin was either of very low efficacy or not efficacious at all (relative risk 0.9, CI 0.81–1) (BMJ 2009;339:b4531). This meta-analysis included 157 trials (over 10 000 patients), although the authors did point out that many of the trials have been of poor quality. The accompanying editorial rightly points out that the confidence intervals reach 1, suggesting there may be some benefit (BMJ 2009;339:b4596). Indeed, we know from primary prevention trials in non-diabetics that aspirin offers some benefit, but that the benefit is too small to be worth taking a tablet every day for ( NNT 1666/y to prevent 1 CV event).

What does this mean in practice? 1 Aspirin is no longer recommended for PRIMARY prevention of CVD in diabetics.